Registration Form

We welcome you to join our vibrant parish community at St. Raphael Parish. We stay centered in the Eucharist and are committed to living a faith of welcome, love and service to one another.

Please fill out the form as completely as possible. Feel free to contact the Parish Office at 440-871-1100 with any questions.

Family Information
Last Name
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Household Address
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Phone Number --
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Household Email Address
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Registration For:
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May We Include Your Family Information in a Parish Directory?
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Are you interested in online giving?
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Online Giving allows you to make regular offertory contributions or special one-time donations without writing checks or worrying about cash. A link to our secure site will be emailed to you.
Head of Household
Name
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Maiden Name, if Applicable
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Cell Phone Number --
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E-mail Address
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Birth Date //
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Gender
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Marital Status
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If married, were you married in a Catholic Ceremony?
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Marriage Date //
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Religion
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Sacraments Received
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Occupation
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Spouse
Name
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Maiden Name
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Cell Phone Number --
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E-mail Address
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Birth Date //
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Gender
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Marital Status
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Religion
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Sacraments Received
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Occupation
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Child #1
Please include all children, college-age and younger. Upon graduation, they are encouraged to register independently.
Name
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Birth Date //
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Gender
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Religion
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Sacraments Received
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School Attending
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Child #2
Name
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Birth Date //
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Gender
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Religion
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Sacraments Received
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School Attending
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Child #3
Name
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Birth Date //
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Gender
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Religion
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Sacraments Received
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School Attending
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Child #4
Name
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Birth Date //
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Gender
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Religion
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Sacraments Received
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School Attending
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Additional Members
Please list any additional members of your household.
Text (Multiple Lines)
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Please list name, date of birth, gender, and sacraments received.
Questions/Comments
Text (Multiple Lines)
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Spam Capture
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